长期冬泳对老年人骨健康指标的影响

目的了解长期冬泳运动对老年人骨密度和骨代谢指标的影响。方法以114名55~65岁的老年人为研究对象,分为冬泳组和对照组。采用Sahara Clinical Bone Sonometer超声骨密度测定仪测定跟骨宽带超声衰减(BUA)、超声声速(SOS)、定量超声指数(QUI)和骨密度(BMD)。采用MODULAR全自动生化分析仪测定血清钙(Ca)、磷(P)和碱性磷酸酶(ALP)含量,同时采用S200型酶标仪测定骨钙素(BGP)、抗酒石酸酸性磷酸酶5b(TRACP5b)含量。结果冬泳组男性老年人的BUA、SOS、QUI和BMD均值高于对照组,且存在非常显著的组间差异(P0.01);冬泳组和对照组老年人的ALP均值存在显著的组间差异(P0.05),血清Ca、BGP、TRACP5b均值的组间差异非常显著(P0.01)。结论冬泳运动能够有效改善老年人的骨代谢能力和男性老年人的骨密度,对提高老年人整体健康水平有积极意义,是适合老年人锻炼的有益运动。     

老年男性骨质疏松患者血清胰淀素与骨密度及骨转换生化指标的关系

目的探讨老年男性骨质疏松患者血清胰淀素(Amylin)水平的变化及其与骨密度(BMD)及骨转换生化指标的关系。方法采用酶联免疫法(ELISA)测定89例老年男性骨质疏松患者和50例正常男性老年人血清Amylin、骨碱性磷酸酶(BAP)、骨钙素(BGP)、I型胶原氨基末端肽(NTX),采用美国NORLAND XR-46 Excell-plus双能X线骨密度测定仪分别测定正位腰椎(L2-L4)及左侧股骨颈BMD。结果老年男性骨质疏松患者正位腰椎及左侧股骨颈BMD、血清Amylin、BAP、BGP水平较正常男性老年人明显降低(均P<0.01),血清NTX水平较正常男性老年人明显升高(P<0.01)。老年男性骨质疏松患者血清Amylin水平与患者正位腰椎及左侧股骨颈BMD、血清BAP、BGP水平呈明显正相关(r=0.598,r=0.652,r=0.576,r=0.584,均P<0.01),与患者血清NTX水平呈明显负相关(r=-0.673,P<0.01)。结论血清胰淀素水平降低在老年男性骨质疏松的发病中可能发挥重要作用。     

老年男性骨质疏松患者血清胰岛素样生长因子、内皮素与骨钙素及骨转换生化指标的相关性研究

目的 探讨老年男性骨质疏松患者血清胰岛素样生长因子、内皮素与骨钙素及骨转换生化指标水平的变化及相关性。方法 采用酶联免疫法（ELISA）检测70例老年男性骨质疏松组（OP）及50例正常老年男性对照组（NS）的血清胰岛素样生长因子（IGF-1）、内皮素（ET-1）、骨钙素（BGP）、抗酒石酸酸性磷酸酶-5b（TRACP-5b）,采用美国NORLAND双能X线骨密度仪测定腰椎（L2-4）的骨密度。结果 与对照组比较,OP患者的血清IGF-1、BGP和腰椎BMD明显的降低（P<0.05）,而血清ET-1、TRACP-5b明显升高（P<0.05）;老年男性血清IGF-1与BMD、BGP成明显的正相关（P<0.05）,而与ET-1、TRACP-5b成明显的负相关（P<0.05）,ET-1与IGF-1、BMD、BGP成明显的负相关（P<0.05）,而与TRACP-5b成明显的正相关（P<0.05）。结论 血清内皮素的升高,胰岛素样生长因子的降低在老年男性骨质疏松患者的发病机制中可能发挥重要的作用。     

63例老年男性慢性阻塞性肺病患者骨密度和骨代谢的改变

目的 通过测定慢笥阻塞性肺病（ＣＯＰＤ）患骨和骨代谢的变化,探讨ＣＰＯＤ骨质质松的发生机提。方法 应用双能Ｘ线吸收测定仪（ＤＥＸＡ）对６３例老年男性ＣＯＰＤ患进行腰椎、股骨近端骨密度（ＢＭＤ）测定,酶联免疫法（ＥＬＩＳＡ）测定血骨钙素（ＢＧＰ）、抗酒石酸盐酸性磷酸酸（ＴＲＡＰ）、１型前胶原Ｃ端肽（ＰＩＣＰ）、尿胶原吡并酚（ＰｙＤ）、脱氧吡啶并酸（Ｄ－ＰｙＤ）,并与３０例男性对照组比较。结果 老     

Cross-sectional evaluation of bone metabolism in men.

There are relatively few data concerning age-related changes of bone turnover in men. The aim of the study was to evaluate age-related changes of the levels of serum and urinary biochemical markers of bone metabolism in a large cohort of 934 men aged 19-85 years and to investigate their association with bone mineral density (BMD). Bone formation was evaluated using serum levels of osteocalcin (OC), bone alkaline phosphatase (BAP), and N-terminal extension propeptide of type I collagen (PINP). Bone resorption was evaluated by measurement of urinary excretion of beta-isomerized C-terminal telopeptide of collagen type I beta-CTX) of free deoxypyridinoline (fDpyr) and total Dpyr (tDPyr) and of the serum level of beta-CTX. Levels of biochemical bone markers were very high in young men and decreased rapidly until the age of 40 years and then more slowly until 60 years of age. After the age of 60 years, markers of bone formation remained stable while resorption markers showed a moderate and variable increase with aging. Serum and urinary beta-CTX levels were elevated only in about 5% of elderly men. The age-related increase of urinary excretion of tDpyr and of its free and peptide-bound fractions was related to the presence of elevated levels in a subgroup of about 15% of elderly men. Before 60 years of age, levels of biochemical bone markers were not correlated with BMD, whereas after 60 years of age, they were correlated negatively with BMD. After adjustment for age and body weight, BMD in men with the highest levels of biochemical bone markers (i.e., in the upper quartile) was 1.8-12.5% (i.e., 0.25-0.89 SD) lower than in men with levels of biochemical bone markers in the lowest quartile. In conclusion, bone turnover in men is high in young adults and decreases to reach a nadir at 55-60 years of age. After the age of 60 years, bone resorption markers--but not bone formation markers--increase in some men and are associated with lower BMD, suggesting that this imbalance is responsible for increasing bone loss in elderly men.     

妊娠妇女性激素、骨密度、骨代谢生化指标的变化及相关性研究

目的：探讨妊振妇女骨密度和骨代谢的变化及其与性激素的关系。方法：随机选取63例健康脑力劳动孕妇和21例健康脑力劳动妇女分别测定骨密度,血清Ca、P、ALP、BGP和E2、P、FSH、LH、PRL以及尿HP/Cr、Ca/Cr比值。结果：孕期骨密度虽有下降但无显变化（P＞0.05),ALP和BGP在晚孕期有显变化（P＜0.05)且此变化与E2成正相关（r=0.61、0.36)。结论：妊娠期骨密度虽无明显变化,但晚孕期骨转换率明显增加且与E2呈正相关。提示可通过测定E2了解孕期骨代谢情况,并及时予以补钙等措施可能有益。     

118例甲亢患者骨密度及骨代谢指标的研究

目的：为探讨甲亢患者骨密度与骨代谢指标的改变。方法：本文测定了１１８例甲亢患者腰椎（Ｌ２～４）及股骨上端（Ｎｅｃｋ、Ｗａｒｄ三角、Ｔｒｏｃｈ）骨密度、血清骨钙素（ＢＧＰ）、甲状旁腺素中间片段（ＰＴＨ－ｍ）及尿脱氧吡啶啉（Ｄｐｄ）。结果：甲亢患者骨密度低于正常对照组，ｔ检验具显著差异（ｐ＜０．０１）、血清ＢＧＰ及Ｄｐｄ高于正常对照组，ｔ检验具显著差异（ｐ＜０．０１），与骨密度呈负相关ｒ＝－０．２１３５、－０．２０５０（ｐ＜０．０５）；而ＰＴＨ－ｍ低于正常对照组，与骨密度无相关性ｒ＝０．０８３０（ｐ＞０．０５）。结论：甲亢为高转换型骨质疏松，ＢＧＰ、Ｄｐｄ可作为骨形成及骨吸收的敏感指标     

Serum intact molecule of bone Gla-protein in patients with abnormal bone and calcium metabolism

A circulating level of bone Gla-protein (BGP) has been estimated one of the most promising markers for bone turnover in patients with metabolic bone diseases. Although previous bone histomorphometric studies have revealed that serum BGP levels are mainly related to osteoblastic bone formation, multiple immunoreactive forms of BGP present in uremic sera are attributed to both osteoclastic bone resorption and decreased renal metabolism itself. Chromatography and cross-reactivity tests showed that an immunoradiometric assay (IRMA) for BGP specifically recognizes intact molecules of BGP and excludes BGP fragments found in uremic sera. Serum levels of BGP determined by IRMA were found significantly higher than those determined by radioimmnoassay. Elevated serum BGP levels determined by IRMA in primary hyperparathyroidism decreased and returned within the reference range more than 1 year following successful parathyroidectomy. Intermittent oral administration of high dose of 1,25 (OH)₂D₃ enhanced elevated serum BGP levels determined by IRMA which significantly increased from the initial levels at week 4 and at week 8, afterwards gradually returning to the basal levels at week 16. In addition, similar treatment effects were observed in serum prcollagen type I c-terminal peptide (P1CP), a marker for bone matrix formation. In conclusion, the measurement of serum BGP concentration utilizing IRMA, which specifically recognizes intact whole molecules of BGP, is useful to assess bone turnover and treatment effects in metabolic bone diseases, particularly in hyperparathyroidism.     

T2DM伴骨质疏松Cys-C、25(OH)D3、BGP变化及临床意义

目的 探究老年2型糖尿病（T2DM）伴骨质疏松患者血清胱抑素C（Cys-C）、25羟维生素D3[25(OH)D3]、骨钙素（BGP）水平变化，并分析其对骨质疏松性骨折的预测价值。方法 选取2020年2月至2022年5月本院88例老年T2DM伴骨质疏松患者作为研究组，另选同期88例老年T2DM骨量减少患者作为对照A组，88例老年T2DM骨量正常患者作为对照B组。比较各组血清Cys-C、25(OH)D3、BGP水平、血糖指标、血脂指标、骨矿物质密度（BMD），分析研究组血清各指标水平与血糖指标、血脂指标、BMD的相关性。研究组均行常规对症治疗6个月，依据是否发生骨质疏松性骨折分为发生者、未发生者，比较治疗前后血清各指标水平及变化值，分析其对骨折的预测价值。结果 研究组血清Cys-C水平高于对照A组、对照B组，25(OH)D3、BGP水平低于对照A组、对照B组（P＜0.05）；Cys-C水平与BMD呈负相关，25(OH)D3、BGP水平与BMD呈正相关（P＜0.05）；发生者治疗前后血清Cys-C水平高于未发生者，25(OH)D3、BGP水平低于未发生者，各指标变化值低于未发生者（P＜0.05）；血清各指标变化值降低可增加骨质疏松性骨折发生风险（P＜0.05）；治疗3个月后血清各指标变化值联合预测骨质疏松性骨折的AUC大于治疗1个月后（P＜0.05）。结论 老年T2DM伴骨质疏松患者血清Cys-C水平升高，25(OH)D3、BGP水平降低，联合检测其水平变化对骨质疏松性骨折具有一定预测价值。     

长春市35?79岁人群骨代谢指标与骨密度相关性研究

目的研究抗酒石酸酸性磷酸酶(TRACP)、Ⅰ型胶原C端肽(CTX-1)、骨特异性碱性磷酸酶(BALP)、降钙素(CT)、骨钙素(BGP)、甲状旁腺激素(PTH)、25-羟基维生素D3(25(OH)D3)与前臂远端骨密度相关关系。方法采用美国Osteometer Medi Tech公司生产的DTX-200型骨密度仪检测受试者非受力侧前臂桡、尺骨远端三分之一处骨密度(BMD);采用美国贝克曼公司全自动化学发光免疫分析仪、美国Thermo公司酶标免疫分析仪检测骨代谢指标;将791例受试者检测结果按不同性别,每5岁为一个年龄段分组;应用SPSS13.0分析软件进行统计分析。结果35～49岁人群TRACP、CTX-1、BALP、BGP等指标性别间不存在差异;50～79岁人群性别间差异显著,女性高于男性。TRACP、CTX-1与BMD负相关;女性BALP、BGP在50～64年龄段明显升高,与BMD负相关,65岁以后开始下降。25(OH)D3与BMD正相关;CT降低出现在65～79岁年龄段,与BMD显著正相关。结论骨代谢指标测定是监测骨量变化及骨质疏松早期诊断的重要技术手段。     

Sexual differences in bone markers and bone mineral density of normal Chinese

We measured bone mineral density (BMD) at lumbar (L2–L4) vertebrae and proximal femurs of 385 healthy Chinese women aged 40–70 years and 156 healthy Chinese men aged 20–85, and four markers—bone alkaline phosphatase isozyme (BAP), procollagen-I C terminal propeptide (PICP), osteocalcin (BGP) in serum, and a bone resorption marker, urinary cross-linked N-telopeptide of type I collagen (NTX), of these subjects. The results indicate that in postmenopausal women, levels of all the markers increased with age. In men, serum BAP, PICP, and urinary NTX decreased significantly, and serum BGP decreased with borderline significance (P=0.08). With increasing age, bone density decreased at both sites in post-menopausal women and at the proximal femur in men. The lumbar bone density showed no significant age-related changes in men. In premenopausal women, BMD at either site showed no significant change with increasing age. Despite the different trends between men and women of agerelated changes in BMD and bone markers, bone density of both proximal femur and spine in both sexes correlated inversely with levels of the bone markers in a manner independent of age or body weight. The meaning of opposite age effects on bone markers in men and women needs further investigation. In addition, higher bone marker levels, implying faster bone turnover rate, are associated with lower BMD in both sexes.     

Biochemical Markers of Bone Turnover and Bone Loss at the Lumbar Spine and Femoral Neck: The Taiji Study

The purpose of this study was to ascertain whether biochemical markers of bone turnover predict bone loss. The survey was carried out in Taiji, Wakayama Prefecture, Japan. From a list of inhabitants aged 40–79 years, 400 participants (50 men and 50 women in each of four age groups) were selected randomly. Bone mineral density (BMD) was measured, and blood and urine samples of all participants were examined to obtain values for eight biochemical markers: alkaline phosphatase (ALP), bone Gla protein (BGP), type I procollagen (carboxyterminal peptide of type I procollagen; PICP), cross-linked carboxyterminal telopeptide region of type I collagen (ICTP), and urinary excretion of calcium (Ca), phosphate (P), pyridinoline (Pyr), and deoxypyridinoline (D-Pyr). Each marker was evaluated as a predictor of the rate of bone change in lumbar spine and femoral neck BMD over a 3-year period. The value of Pyr was significantly related to the change of lumbar spine BMD in men (P= 0.009), and that of BGP was found to be significant in women (P= 0.045). By contrast, none of the bone markers significantly correlated with bone loss at the femoral neck. The coefficient of determination at the lumbar spine was 5% and 7% at the femoral neck only. We conclude that biochemical markers of bone turnover cannot predict bone loss rates in middle-aged or elderly Japanese men and women over a 3-year period with sufficient accuracy for use in clinical decision making. Received: 26 January 1998 / Accepted: 9 July 1998     

糖皮质激素诱导胰岛素样生长因子1降低对原发性肾病综合征患者骨代谢的影响

目的 观察糖皮质激素（GC）治疗的原发性肾病综合征（PNS）患者胰岛素样生长因子1（IGF-1）变化,探讨其水平改变对PNS患者骨代谢的影响及意义。 方法 以本院2008年1月至2009年8月临床资料完整的PNS患者39例为对象。口服泼尼松0.8~1.0 mg&#8226;kg-1&#8226;d-1,完全缓解2周后,以每2周减去原剂量的5％～10％的方式减量。最终每日或隔日5～10 mg维持（总疗程>24周）。测定应用激素前、治疗第4、8、12、24周末血白蛋白、24 h尿蛋白量、血清钙、磷、甲状旁腺激素（PTH）、25羟基维生素D3（25-（OH）D3）、骨钙素（BGP）、I型胶原吡啶交联C终端肽（CTx）及尿钙/肌酐;双能X线骨密度仪检测患者骨密度（BMD）;酶联免疫法测定血清IGF-1水平。使用Pearson 相关分析探讨IGF-1与骨代谢改变的关系。 结果 36例完成随访,并具备完整临床数据。治疗第4、8、12和24周与治疗前比较,患者血钙、25-（OH）D3水平均呈时间依赖性升高（P < 0.05）,相关分析提示,与尿蛋白量呈负相关 （r=-0.749,r=-0.831,P < 0.05）。骨形成指标血BGP、IGF-1水平呈时间依赖性降低（P < 0.05）,骨吸收指标CTx逐渐升高,至第12周起差异有统计学意义（P < 0.05）。第4周各部位BMD与治疗前差异均无统计学意义;第8周起腰椎（L1~L4）BMD值较治疗前显著下降（P < 0.05）;第 24 周,股骨颈和股骨干的BMD与治疗前差异有统计学意义（P < 0.05）。PNS患者经糖皮质激素治疗后,IGF-1与BMD和BGP呈正相关（r=0.495和r=0.896,均P < 0.05）,与血CTx呈负相关（r=-0.697,P < 0.05）。 结论 糖皮质激素呈时间依赖性导致PNS患者血清IGF-1水平降低。IGF-1下降与患者早期骨形成指标降低、骨吸收指标增高及后期骨密度下降相关。IGF-1途径可能参与GC 引起的PNS患者骨代谢改变。IGF-1有望成为反映或预测糖皮质激素诱导的骨质疏松的新型生化指标。     

Serum osteocalcin (BGP) levels in normal men: a longitudinal evaluation reveals an age-associated increase

Serum levels of bone gla protein (BGP) have been reported to increase with aging and hence to reflect an age-related increase in bone remodeling activity. To evaluate the relationship between aging and serum BGP levels in a study of longitudinal design, we measured BGP concentrations in 77 normal men at 6 month intervals over a 3 year period. Mean BGP levels at the onset (4.95 +/- 1.5 ng/ml) increased significantly during the study (p = 0.004), and the mean of individual BGP slopes was positive (0.38 +/- 0.6 ng/ml per year, p = 0.0001). The rate of change in BGP was not related to serum creatinine levels or dietary calcium intake.     

The Relationship of Ghrelin and Adiponectin with Bone Mineral Density and Bone Turnover Markers in Elderly Men

Body weight is commonly considered a significant predictor of bone mineral density (BMD). Adiponectin, an adipocyte-derived hormone, could modulate BMD. Moreover, recent studies have reported that ghrelin is able to stimulate bone formation. In this study, we investigated any associations of adiponectin and ghrelin serum levels with bone turnover markers and BMD in elderly men. In 137 men aged 55 years and older (mean age 67.4 +/- 5.4 years, mean body mass index [BMI] 26.6 +/- 3.4 kg/m(2)), we evaluated serum adiponectin, serum ghrelin, body composition (fat mass and lean mass), BMD, bone alkaline phosphatase (ALP), and the carboxy-terminal telopeptide of type I collagen (betaCTX). Ghrelin showed significant correlations with BMD at the femoral neck (r = 0.25, P < 0.01), total femur (r = 0.22, P < 0.05), and whole body (r = 0.18, P < 0.05). However, after adjusting for age, BMI, and calcium intake, the correlation remained significant only for femoral neck BMD. Ghrelin showed a significant correlation with lean mass but not with fat mass and bone turnover markers. Adiponectin showed a positive association with both bone ALP and betaCTX; the correlation between adiponectin and bone ALP (r = 0.25, P < 0.01) remained significant after adjusting for confounding variables. No significant correlations between adiponectin and BMD at all skeletal sites were observed. In conclusion, our study suggests that in elderly Italian men serum ghrelin was significantly associated with femoral neck BMD and that adiponectin was positively associated with bone ALP. Further studies are needed to elucidate the role of adipocytokines in bone metabolism.     

原发性肾病综合征患者血清胰岛素样生长因子1的变化及其与骨代谢的关系

目的 探讨原发性肾病综合征（PNS）患者血清胰岛素样生长因子1（IGF-1）的变化及其与骨代谢指标之间的关系。评价IGF-1在PNS患者骨代谢异常机制中的临床价值。方法 随机选取2008年1月至2009年5月临床资料完整的慢性肾脏病（CKD）1、2期PNS患者30例为对象;健康体检者61例为健康对照组。测定血清IGF-1、钙、磷、PTH、25羟基维生素D3[25-（OH）D3]、骨钙素（BGP）、I型胶原吡啶交联C终端肽（CTx）及尿钙/尿肌酐（UCa/Cr）。双能X线骨密度仪检测患者骨密度（BMD）。 结果 与健康对照组比较,PNS组血Ca、25-（OH）D3及BGP水平显著降低;血CTx水平及UCa/Cr比值显著增高（均P < 0.05）;BMD水平降低[（1.078±0.090） g/cm2 比（1.090±0.062） g/cm2,P > 0.05],但差异无统计学意义。PNS组血清IGF-1水平显著低于健康对照组,差异有统计学意义[（155.75±17.48） μg/L比（223.17± 16.44） μg/L,P < 0.05],且与24 h尿蛋白量及CTx呈负相关（r = -0.757和r = -0.786,均 P < 0.05）;与血BGP和BMD呈正相关（r = 0.861和r = 0.584,均P < 0.05）。 结论 PNS患者（CKD 1、2期）存在骨代谢异常,表现为骨形成减少、骨吸收增加。血清IGF-1与血BGP、CTx及BMD相关,可作为反映PNS患者骨代谢改变的临床指标之一。     

糖尿病患者血清BGP与骨密度变化的研究

本文应用放射免疫分析方法对60例正常人及74例糖尿病患者的血清BGP进行了测定，并就其与BMD、血Ca、P及AKP等进行比较分析。结果表明：糖尿病患者血清BGP明显降低，而血Ca、P及AKP仍在正常范围．血清BGP与BMD呈负相关。说明血清BGP测定与BMD一样可以作为骨质疏松、糖尿病等代谢性骨病诊断与研究的一种敏感指标。     

血清SM4D水平与绝经后骨质疏松症患者骨密度和骨代谢指标的相关性研究

目的探讨绝经后骨质疏松症(postmenopausal osteoporosis,POP)患者血清4D同型二聚体(SM4D)水平与骨密度(bone mineral density,BMD)和骨转换指标的关系。方法通过双能X线吸收测定法对257例POP患者和90例健康对照者进行BMD测量。通过酶联免疫吸附测定法测定受试者血清SM4D、BAP、BGP和TRACP-5b水平。使用自动电化学发光系统测量I型血清交联N端肽(NTX)、25-羟基维生素D[25(OH)D]和骨钙素的N-mid片段水平(N-MID-OT)。结果与健康对照组相比,POP妇女的SM4D水平显著升高[(1.40±0.33)μg/L vs.(0.58±0.18)μg/L,P=0.006]。SM4D水平与血清TRACP-5b和NTX水平呈正相关,与腰椎和股骨颈BMD、血清BAP和BGP水平呈负相关。SM4D水平与年龄、体质量指数以及血清25(OH)D和N-MID-OT水平之间无相关性。腰椎和股骨颈骨密度(β=-0.354,P<0.001;β=-31.234,P<0.001)和血清BAP水平(β=0.127,P=0.019)是POP患者血清SM4D水平的独立预测因子。结论绝经后骨质疏松症女性SM4D与骨密度和骨转换指标密切相关。     

中药龟丝补骨片对绝经后早期妇女骨转换指标和骨密度的影响

目的 从中医“肾虚”理论出发，观察中药龟丝补骨片对绝经后早期妇女骨转换指标和骨密度的影响。方法 将63例加岁以上的自然绝经1年以上但不超过5年的健康妇女，先完成中医肾虚证症状量化表调查、并采用DEXA测量BMD，根据骨密度值T-score低于-2．0为标准分为绝经后骨质疏松症组(OP)和非骨质疏松症组(NO)，依就诊次序按1：2比率序贯进入尼尔雌醇组(n)和龟丝补骨片组(g)。单盲观察尼尔雌醇和龟丝补骨片的治疗作用6个月。成功随访率达93．65％。治疗前和后第3、6个月分别检测骨转换标志物血清BGP和尿Dpd／Cr，治疗结束时复查BMD。结果 采用龟丝补骨片治疗后，第6个月无论NO组还是0P组，血清BGP水平均显著升高；尿Dpd／Cr比值更早、更显著地降低，在OP组治疗第3、6个月时降低分别有显著和极显著性意义，OP-g组尿Ca^2 ／Cr排出明显下降。干预治疗第6个月，龟丝补骨片和尼尔雌醇都有增加骨量的作用，各组BMD都有不同程度的升高；且发现对治疗的反应性似乎骨质疏松者比非骨质疏松者好，腰椎较股骨好，其中椎体部分最好，股骨颈最差。结论 龟丝补骨片具有保护绝经早期妇女的骨丢失作用，我们认为，这一保护作用主要与抑制骨吸收、促进骨形成有关。     

Serum tartrate-resistant acid phosphatase 5b,but not 5a,correlates with other markers of bone turnover and bone mineral density

Human serum contains two isoforms of tartrate-resistant acid phosphatase (TRACP) known as TRACP 5a and TRACP 5b with pH optima of 5.0 and 5.8, respectively. Preliminary data suggest that serum TRACP 5b is derived from osteoclasts and serum TRACP 5a from some other cells. It has been reported that heparin inhibits TRACP 5a but has no effect on the activity of TRACP 5b. Here we show that heparin has no effect on serum TRACP activity, as determined using our previously published immunoassay, suggesting that the immunoassay does not detect TRACP 5a. The change of serum TRACP 5b activity after 6 months HRT, determined by this immunoassay, correlated significantly with the changes of all markers of bone turnover determined, including serum N- and C-terminal propeptides of type I collagen and urinary-free deoxypyridinoline. Serum TRACP 5b activity was significantly elevated in patients with osteoporosis and had a significant negative correlation with bone mineral density (BMD). Serum TRACP 5a activity, determined by an immunoassay, showed no correlation with serum TRACP 5b activity, with BMD, or with any of the markers of bone turnover. These results show that serum TRACP 5b, but not 5a, reflects the bone resorption rate, and that our TRACP 5b immunoassay may be a specific method for the determination of the bone resorption rate from serum samples.